1. 25 iv 06 Planning for success The high value hip Justin Cobb Chair of Orthopaedics Imperial College London Vijay Kannan, Wael Dandachli, Hardik Patel, Peter Darcy

2. 25 iv 06 Objectives of this talk  1 frames of reference –acetabular and femoral orientation  2 use them to orientate in –resurfacing arthroplasty Precise acetabular position Precise femoral position –A matched couple  3 look at impact on learning

3. 25 iv 06  Resurfacing has a new level of compromise –Best Bone interface On head, or neck? Plan your compromises

4. 25 iv 06 Resurfacing has compromises 2 –Minimise bone resection But plain films are inaccurate 44 looks too small, will notch neck 48 looks better, but was too big on table

5. 25 iv 06 Resurfacing has compromises 3  Can’t alter: Neck angle and neck anteversion  Can alter: neck length head on neck angulation and translation osteochondroplasty often needed

6. 25 iv 06 Ct based system  Freeware for training and planning – www.acrobot.co.uk Low dose protocol Segmentation and orientation by radiographer

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9. What does it cost?  Time: –2 minutes of fun preop with your patient –Time neutral in theatre  Effort –Organising the system in your hospital  Money –Ct, processing, navigation:

10. 25 iv 06 Precise resurfacing  For the high value hip –Navigation Should become ‘standard of care’ –Preop planning Will make it quicker and safer